TITLE

A PROSPECTIVE STUDY TO ASSESS RESPONSE TO 3 MONTHS OF COMBINATION TREATMENT IN CHRONIC HEPATITIS C INFECTION

AUTHOR(S)
Kumar, N.; Teague, B.; Paine, P.; Mukerjee, S.; Higham, A.; Brown, C.; Stewart, A.; Askew, T.; Davies, A.; Polland, M.; Keating, J.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA107
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Current recommendations, including NICE guidance, suggest treating genotype I hepatitis C with combination treatment for 12 months and genotype II/III for 6 months. However, this prolonged course of treatment puts enormous strain on budgets, thereby limiting its use and the length of this treatment reduces compliance. Our prospective study recruited 51 patients, following ethics committee approval, of whom 33 (65%) were male and 18 (35%) were female, age range 22-56 years. 44% were genotype I and 56% were genotype II/III. The majority of these patients (80%) had mild to moderate hepatitis as assessed by the Ishak scoring system. 4 (8%) had severe hepatitis and 6 (12%) had cirrhosis. They received 3 months of combination treatment, consisting of weekly PEG interferon 1.5 mcg/kg and Ribavarin 400 mgm twice daily. To improve compliance PEG interferon was given either at the hepatology clinic, or at the GP's surgery. Monthly PCR testing assessed their response to treatment. We achieved 96% compliance. Treatment in one patient had to be temporarily stopped due to severe anaemia. The side effect profile in our study was similar to other major studies. Surprisingly our patients with leucopenia responded well to dose modification. At the end of 3 months treatment 70% of genotype II/ill and 52% of genotype I were hepatitis C PCR negative. Non-responders were treated with a further course of treatment as per NiCE guidance. This study shows that 3 months treatment may be adequate in the majority of patients with mild to moderate hepatitis C. This shortened course of treatment would improve compliance, reduce side effects, and have a major impact on the economy of treating this condition, thereby making this treatment widely available.
ACCESSION #
9748016

 

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